Risks of ACTH therapy for West syndrome following BCG vaccination.
Epilepsy Behav
; 118: 107924, 2021 05.
Article
em En
| MEDLINE
| ID: mdl-33838621
ABSTRACT
OBJECTIVE:
Bacille de Calmette et Guérin (BCG) is a live vaccine for tuberculosis that is administered to all infants in Japan. Adrenocorticotropic hormone (ACTH) therapy for West syndrome (WS) causes immunosuppression and may result in BCG infection after BCG vaccination. We evaluated the safety of ACTH therapy initiated shortly after BCG vaccination.METHODS:
We analyzed patients with WS who received ACTH therapy between 2005 and 2018. We evaluated the interval between BCG and ACTH therapy, and the rate of BCG infection during and after ACTH therapy, by retrospective chart review.RESULTS:
Seventy-nine patients were included in the analysis. Twenty-three patients received ACTH therapy prior to BCG vaccination. For the remaining 56 patients, the median interval between BCG vaccination and the start of ACTH therapy (BCG-ACTH interval) was 91.5 (range 14-280) days. The BCG-ACTH interval was shorter in patients with unknown than in those with known etiologies. It was <8â¯weeks in 13 patients (10 with unknown and 3 with known etiologies). The minimum BCG-ACTH interval was 14â¯days. Six patients with epileptic spasms received BCG vaccinations because physicians did not recognize their seizures. None of the patients developed BCG infection.CONCLUSION:
No patients who received ACTH therapy after BCG, even at an interval of 8â¯weeks, developed BCG infection. The timing of ACTH therapy initiation should be based on the risk of BCG-related adverse events and the adverse effects of any delay.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Espasmos Infantis
/
Vacina BCG
/
Hormônio Adrenocorticotrópico
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
/
Infant
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article